Provider Demographics
NPI:1326537614
Name:HOLZSHU, NANCY LEE
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LEE
Last Name:HOLZSHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 BAYPOINTE CT
Mailing Address - Street 2:
Mailing Address - City:REEDVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22539
Mailing Address - Country:US
Mailing Address - Phone:804-453-4290
Mailing Address - Fax:
Practice Address - Street 1:176 BAYPOINTE CT
Practice Address - Street 2:
Practice Address - City:REEDVILLE
Practice Address - State:VA
Practice Address - Zip Code:22539
Practice Address - Country:US
Practice Address - Phone:804-453-4290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA22020058235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2202005862Medicaid